Reverse slipped capital femoral epiphysis

Slipped capital femoral epiphysis (SCFE) is a rare occurrence in the paediatric hip. Diagnosis is challenging. It may have an insidious onset. It has potentially devastating consequences for the paediatric hip. There may also be sequelae that persist until adulthood. The femoral epiphysis typically remains in the acetabulum, and the femoral metaphysis displaces anterosuperiorly, leading to the typical sequelae of a shortened, externally rotated leg that exhibits obligate external rotation with flexion. The authors present a case of a 'reverse SCFE'. To the authors' knowledge, it is the first case in the literature of a reverse SCFE. We describe the orthopaedic management of this case with a rethinking of basic surgical procedures to ensure the physiological acetabular-femoral alignment was restored.